NPIMap

Organization Active NPI

Chronic Pain Treatment Centers

  • Pain Medicine Physician
  • Frederick, MD
National Provider Identifier
1184971509
Registry record updated Oct 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine PhysicianTaxonomy code 208VP0000X
Legal business name
CHRONIC PAIN TREATMENT CENTERS
Practice address
8435 Progress Dr Ste Ee
Frederick, MD 21701-4981
Phone
(301) 624-5390
Fax
(301) 624-5393
NPI assigned
Aug 6, 2012
Last updated
Oct 25, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Gloria Corbin
Title
Director of Finance
Phone
(301) 732-6300

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Clinic/Center 261QP3300X 10554640 MD
Pain Medicine Physician 208VP0000X NU Primary

Addresses

Primary practice location

8435 Progress Dr Ste Ee
Frederick, MD 21701-4981

Mailing address

8435 Progress Dr Ste Ee
Frederick, MD 21701-4981
Phone (301) 624-5390

Other names 1

  • Frederick Spine & Rehab Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20241114003065 MD Part B Supplier - Clinic/Group Practice 8921230194 Receives reassigned benefits from 3 practitioners
Practice locations: Frederick, MD

National Provider Directory

National Provider Directory

Locations

915 Toll House Ave
Ste 103
Frederick, MD 21701
Phone (301) 624-5390

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1344211200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729814400000",
    "number": "1184971509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8435 PROGRESS DR STE EE",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217014981",
            "telephone_number": "301-624-5390",
            "fax_number": "301-624-5393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8435 PROGRESS DR STE EE",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217014981",
            "telephone_number": "301-624-5390",
            "fax_number": "301-624-5393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHRONIC PAIN TREATMENT CENTERS",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-06",
        "last_updated": "2024-10-25",
        "certification_date": "2024-10-25",
        "status": "A",
        "authorized_official_last_name": "CORBIN",
        "authorized_official_first_name": "GLORIA",
        "authorized_official_title_or_position": "DIRECTOR OF FINANCE",
        "authorized_official_telephone_number": "301-732-6300"
    },
    "taxonomies": [
        {
            "code": "261QP3300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Pain",
            "state": "MD",
            "license": "10554640",
            "primary": false
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Frederick Spine & Rehab",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Frederick, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.